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CME / ABIM MOC

Case Challenges in Newly Diagnosed Multiple Myeloma

  • Authors: Sandy Wong, MD
  • CME / ABIM MOC Released: 3/17/2023
  • Valid for credit through: 3/17/2024, 11:59 PM EST
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  • Credits Available

    Physicians - maximum of 1.00 AMA PRA Category 1 Credit(s)™

    ABIM Diplomates - maximum of 1.00 ABIM MOC points

    You Are Eligible For

    • Letter of Completion
    • ABIM MOC points

Target Audience and Goal Statement

This activity is intended for community-based hematologists/oncologists.

The goal of this activity is for learners to be better able to evaluate patients with newly diagnosed MM and select appropriate therapy in this setting.

Upon completion of this activity, participants will:

  • Have greater competence related to
    • Selecting optimal, individualized first-line therapy in patients with newly diagnosed MM
    • Assessing risk status in patients with MM
    • Managing adverse events associated with therapy for MM
  • Demonstrate greater confidence in their ability to
    • Select personalized therapy for patients with newly diagnosed MM


Disclosures

Medscape, LLC requires every individual in a position to control educational content to disclose all financial relationships with ineligible companies that have occurred within the past 24 months. Ineligible companies are organizations whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

All relevant financial relationships for anyone with the ability to control the content of this educational activity are listed below and have been mitigated. Others involved in the planning of this activity have no relevant financial relationships.

Disclosures for additional planners can be found here.


Faculty

  • Sandy Wong, MD

    Associate Professor
    Division of Hematology/Oncology
    Helen Diller Family Comprehensive Cancer Center
    University of California, San Francisco
    San Francisco, California

    Disclosures

    Sandy Wong, MD, has the following relevant financial relationships:
    Consultant or advisor for: Catalent Biologics; Dren Biosciences; Sanofi
    Research funding from: Bristol Myers Squibb Company; Caleum; Fortis; Genentech; GlaxoSmithKline; Janssen; Patient Discovery

Editors

  • Megan Whitney, DMD

    Medical Education Director, Medscape, LLC 

    Disclosures

    Megan Whitney, DMD, has no relevant financial relationships. 

  • Tristin Abair, PhD

    Senior Medical Writer, Medscape, LLC 

    Disclosures

    Tristin Abair, PhD, has no relevant financial relationships. 

Compliance Reviewer

  • Amanda Jett, PharmD, BCACP

    Associate Director, Accreditation and Compliance, Medscape, LLC

    Disclosures

    Amanda Jett, PharmD, BCACP, has no relevant financial relationships.

Peer Reviewer

This activity has been peer reviewed and the reviewer has no relevant financial relationships.


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Interprofessional Continuing Education

In support of improving patient care, Medscape, LLC is jointly accredited with commendation by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

    For Physicians

  • Medscape, LLC designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit(s)™ . Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.0 MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit. Aggregate participant data will be shared with commercial supporters of this activity.

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This activity is designed to be completed within the time designated on the title page; physicians should claim only those credits that reflect the time actually spent in the activity. To successfully earn credit, participants must complete the activity online during the valid credit period that is noted on the title page. To receive AMA PRA Category 1 Credit™, you must receive a minimum score of 70% on the post-test.

Follow these steps to earn CME/CE credit*:

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CME / ABIM MOC

Case Challenges in Newly Diagnosed Multiple Myeloma

Authors: Sandy Wong, MDFaculty and Disclosures

CME / ABIM MOC Released: 3/17/2023

Valid for credit through: 3/17/2024, 11:59 PM EST

processing....

The following cases are modeled on the interactive grand rounds approach. The questions within the activity are designed to test your current knowledge. After each question, you will be able to see whether you answered correctly and read evidence-based information that supports the most appropriate answer choice. The questions are designed to challenge you; you will not be penalized for answering the questions incorrectly. At the end of the activity, there will be a short post-test assessment based on the material presented.

CASE 1: PATIENT HISTORY AND PRESENTATION

Bethany is a 64-year-old principal at an elementary school. She has been married for 40 years and has 2 adult children and 4 grandchildren. She is active and healthy, with a history of well-controlled hypertension and hypothyroidism. She had mild atrial fibrillation following COVID-19 infection 3 years ago, which has now improved and does not require medication. She presents to her primary care physician (PCP) with worsening back pain, and a chest x-ray shows multiple lytic lesions. Biopsy confirms the presence of plasma cells and she is referred to a hematologist. Her hematology workup is summarized in Table 1.

Table 1. Bethany's Hematology Workup

  Results
Demographics/patient information
  • 64 years old, female
  • Height: 65 in; weight: 155 lb
  • BMI: 25.8
Personal and family medical history
  • History of well-controlled hypertension, hypothyroidism
  • History of mild atrial fibrillation, not requiring medication
  • Current medications include lisinopril and levothyroxine
  • No major surgeries
  • No family history of cancer
Physical examination
  • No lymphadenopathy
  • Tenderness in lower back
  • BP: 125/65 mm Hg; heart rate: 70 bpm
  • ECOG PS: 0
CBC and blood chemistry
  • WBC count: 9000/mm3
  • HGB: 10 g/dL
  • Platelets: 175 × 109/L
  • Creatinine: 0.8 mg/dL
  • Albumin: 3.2 g/dL
  • eGFR: 70 mL/min/1.73 m2
  • Calcium: 9.7 mg/dL
Myeloma laboratory evaluations
  • M-protein: 1.7 g/dL
  • SIFE: IgG kappa
  • IgG: 2000 mg/dL
  • Kappa free light chain: 356 mg/L
  • Beta-2 microglobulin: 5.7 mg/L
FISH
  • Ordered and waiting on results
PET/CT
  • Multiple FDG-avid lytic lesions through the axial and appendicular skeleton
Bone marrow biopsy
  • Bone marrow showed 60% kappa-restricted plasma cells on the core biopsy
Abbreviations: BMI, body mass index; BP, blood pressure; CBC, complete blood count; CT, computed tomography; ECOG, Eastern Cooperative Oncology Group; eGFR, estimated glomerular filtration rate; FDG, fluorodeoxyglucose; FISH, fluorescence in situ hybridization; HGB, hemoglobin; IgG, immunoglobulin G; PET, positron emission tomography; PS, performance status; SIFE, serum immunofixation electrophoresis; WBC, white blood cell.
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